Most prostate abscesses are complications of acute bacterial prostatitis, which mostly occur at the age of 50~60. Half of the patients have acute urinary retention, frequency of urination, dysuria, rectal discomfort, urethral suppurations, and some are accompanied by epididymitis. Today, let's learn about the symptoms, treatment methods, and nursing points of prostate abscesses.
What are the symptoms of prostatic abscess?
1. Systemic symptoms of prostate abscess: high fever, aversion to cold, continuous rise of body temperature, head and body pain, nausea and vomiting
2. Other symptoms of prostate abscess: hematuria and low back pain may occur in individual patients.
3. Local symptoms of prostate abscess: enlarged prostate, obvious tenderness due to heat, and wave sensation in local or whole gland. The abscess protrudes from the posterior urethra, rectum or perineum, and is thin and smelly after rupture. If the urethra is damaged, urine can flow out of the wound. Urethral purulence, hematuria and pyuria. Some patients have acute orchitis and defecation discomfort. Anal digital examination found anal sphincter spasm, prostate enlargement, palpable pain, and wave sensation, of which prostate wave sensation is the most characteristic change.
4. Urinary tract symptoms of prostate abscess: frequent urination, urgent urination, and painful urination. The main manifestations are acute urination difficulty, which can induce acute urine stagnation. When the systemic symptoms are not obvious, "pseudoprostatic hyperplasia" may occur, which is manifested by lower urinary tract obstruction, severe feeling after internal emergency, and worsening pain after defecation.
What is the treatment of prostate abscess?
Treatment includes urethral discharge, incision and drainage of perineum and appropriate antibiotics.
1. Drug treatment: general support and symptomatic treatment, including bed rest, semi-lying position conducive to inflammation restriction, adequate nutrition and liquid intake, physical cooling in case of high fever, correction of electrolyte disorder and acid-base balance, and sedatives and analgesics for severe pain.
2. Physical therapy: local heat treatment can be used for prostate abscess. Simple and common methods such as wax treatment or hot water bag to heat the abdomen and perineum, increase local blood circulation, promote abscess localization and diminish inflammation, but scald should be prevented.
3. Surgical treatment: For general prostate abscess, it is advisable to use perineal prostate puncture and aspiration, and inject antibiotics into the purulent cavity. If the abscess is significantly enlarged and cannot be drained to the urethra or broken to the urethra by itself, abscess incision and drainage may be used. There are two main methods for surgical treatment of prostate abscess: transrectal prostatectomy and transperineal prostatectomy. Among them, transrectal prostatectomy is applicable to the abscess around the posterior lobe of the prostate. The advantage of this method is that it is located under the rectal mucosa, easy to operate, and the pus flows out. Transperineal prostatotomy and drainage, incision and drainage on both sides of the midline, the advantage of this method is adequate drainage without leaving dead space and false passage.